摘要
目的研究国内宜昌枸橼酸芬太尼在不同年龄阶段患者脊柱手术麻醉中的药代动力学。方法随机选择不同年龄阶段患者脊柱手术麻醉66例,分为少儿组Ⅰ组(6-16岁),中青年组Ⅱ组(18-50岁)和老年组Ⅲ组(60-82岁)每组22例。麻醉诱导用芬太尼4ug/㎏肘静脉注射,在注药后1、3、5、12、22、32、62、122、242、362min分别抽取桡动脉血标本,用GC/MS检测血浆枸橼酸芬太尼浓度,3P87软件包计算药代动力学参数。结果三组患者注射枸橼酸芬太尼后的血药浓度-时间曲线完全可用开放性三室模型进行描述,血浆枸橼酸芬太尼浓度和t1/2β为Ⅰ组【Ⅱ组【Ⅲ组(P【0.05),CL为Ⅱ组】Ⅲ组】Ⅰ组(P【0.05),t1/2л,t1/2α几乎没有变化(P】0.05),Vc和Vd在Ⅰ组和Ⅱ、Ⅲ组有显著性差别(P【0.05)。经体重校正后三组间地显著性差别(P】0.05)。年龄与t1/2β和CL明显相关(P【0.05)。结论从药代动力学特征得知,临床麻醉应用枸橼酸芬太尼在少儿可遵循成人的用药原则,而在老年人由于t1/2β的延长和CL的降低,较成人应适当减少药用量。
Objective The purpose of this study was to determine the effects of different ages on pharmaclkinetics of fentanyl citrate in patients spinal anesthesia. Thus fentanyl citrate may be used reasonally and safely in clinical practice. Methods Sixty-six patients spinal surgery were divided into 3 age groups. Each group had eight patients. The age of the patients in group Ⅰ ranged from 6-16 years,in group Ⅱ 18-50 years and in group Ⅲ 60-82 years . Blood samples were obtained from radial artery 1、3、5、12、22、32、62、122、242、362 min following a bolus injection of fentanyl citrate 4ug/kg-1. Plasma fentanyl citrate concentration was determined by GC-MS. The pharmacokinetic parameters were calculated using 3P87 computer program. Results Plasma fentanyl citrate concentration reached its peak rapidly following a bolus in jection. The plasma conceatration versus time curve was fitted to three-compartment open modle using triexponential equation . Although the patients of different age groups received equivalent dose of fentanyl citrate( 4ug/kg -1) ,plasma concentration was higher in elderly patients. This resulted from a prolonged t1/2βin the elderly patients( group Ⅲ) . Vc and Vd increased significantly in group Ⅱ and Ⅲpatients(P<0. 05) . t1/2л and t1/2α were similar in three groups( P > 0. 05) . CL decreased markedly in group Ⅲ( P < 0. 05) . Significant correlations were found between age and both t1/2β and CL( P<0. 05) . Conclusions Use of fentanyl citrate in children may follow the guidelines suggested for adults. In elderly the dose of fentanyl citrate should be reduced to prolonged t1/2β and decreased CL.
出处
《中国保健营养（下半月）》
2013年第4期548-549,共2页
China Health Care & Nutrition
